Do I need steroids again?

[Mannyd25]

I only starting suffering with my breathing in Feb 2020. I am 49 - never had asthma before. By the time it was bad enough to phone the GP everything was in lockdown, and I’ve not been to the asthma clinic or physically seen the GP.

So, in August despite being put on inhalers and anti-histamines I was hospitalised for 3 days. After steroids, nebs etc I begged to go home. I was put on Symbicort 200/6 (2 puffs am, and 2 puffs evening. Also take Fexofenadine)

5 weeks ago I felt short of breath slightly with constant cold symptoms - GP again gave steroids and Montelukast. Everything cleared up.

This week I am back to breathless again 🙁 - walking at a semi-fast pace or up/down stairs twice - yesterday I was puffing by the end. Took my peak flow which is 250-280. My peak flow when I finished my steroids was 380.

So, do I need to ask for steroids again? I’m allowed extra puffs on the Symbicort but that’s not helping (some immediate help but not long lasting). I’m just fed up now. Desperately trying to not worry the kids (13 & 16), as I’m a widow so health problems worry them.

[twinkly29]

It sounds like you might do. It would definitely be good to speak to a GP or asthma nurse though.

[sarahjane12]

Mannyd25 hi do you use a space with your inhalers.

[Mannyd25 in reply to sarahjane12]

It’s a dry powder inhaler so can’t be used with a spacer

[sarahjane12 in reply to Mannyd25]

I would personally speak back with your doctor/ asthma nurse you should always have the blue inhaler as a emergency really my asthma was diagnosed 4 years ago I smoked at the time and I ended up in a coma with life threatening asthma didn’t know I had it at the time.

[LApaul]

Huh

[LApaul]

You need to speak to your GP or designated nurse re your condition face to face, lockdowns or tiered restrictions do not stop you from attending surgery when you are in need of attention. I am no expert but your peak flow seems on the low side, and a more effective ' preventer ' inhaler sounds necessary.

[Poobah]

Hi Mannyd, I'm sorry to hear that you're struggling with your breathing. Getting the right meds to control your asthma can be trial and error. There are quite a few meds and we all react to them differently. So definitely go back to your GP and explain that your breathing is deteriorating despite taking your prescribed meds religiously. And say you are willing to try a different inhaler to see if that helps you.Symbicort is a combination inhaler that contains steroids plus a long acting bronchodilator. There are other combination inhalers to try. Fostair has finer particles and maybe better for you as it can get further into the lungs. It comes in 100/6 & 200/6 and is more potent than Symbicort.

Keep up the Montelukast and Fexofenadine. Have you been given a Ventolin inhaler? It helps as a short acting bronchodilator, and can be used to address any shortness of breath in between your morning and evening doses of Symbicort/combo inhaler. But it can also be used in a specific way in an emergency if your asthma is suddenly very bad.

Asthma can flare up and even folk who've had asthma for years won't be able to work out why. The response should always be to seek early help from your doctor or asthma nurse.

Right now, your GP may decide to prescribe more oral steroids, but in the medium term they should work with you to explore different meds that suit you and your asthma.

If you can, check out your inhaler technique . I attach a link, but I would say that you should keep your shoulders down while inhaling the dry powder, using the diaphragm to expand the lungs, place your hand on your diaphragm to feel it expand on inhalation. My asthma nurse explained that raising the shoulders is an indication of a shallow breath. So in this Youtube video the girl demonstrating is not a great example as her shoulders are too raised on inhalation. You can use a mirror to watch your technique and practice your technique.

youtu.be/q_Nrzgj6mPE(Not working as expected?)

[Itswonderful]

Do you have a Ventolin inhaler? But speak to GP whatever. Just do it 🤗

[hilary39]

This sounds very stressful! Just wanted to say I'm sorry you're going through this and feeling like you have to shelter your children from how awful you feel. Can you get on the hotline with a nurse ASAP? Do you have an asthma care plan with your GP? If not, it would be great to have this on hand for the future so you know how to step up your meds when you're struggling and what symptoms to look for etc. If you keep it on the fridge, maybe that would help your kids feel like there's a clear plan for when you're not feeling well.

asthma.org.uk/b42999dc/glob...

Take good care and don't dismiss the symptoms. The more our asthma worsens the longer it takes to recover from a flare.

Keep us posted!

[Braces71]

I developed late onset Asthma which rocked and rolled until I was treated by a specialist who put me on a regime of Ventolin Serevent and Flixotide at 2 puffs a day twice a day for each. This stabilised my condition for years. However I was hospitalised with flu two years ago where a doctor insisted I switch to Symbicort 400/12. Plus Ventolin if required. It didn’t work for me as I started wheezing in the early hours. Went to my GP who put me back on my original medication. Since I have not had any problems.

[Mannyd25]

Thank you all. You’ve been far more helpful than my GP surgery where the receptionist declined me a telephone appointment because I phoned at 9.30 rather than 8.30 🙄😬So, today I’ve not been worse - although no better either. GP surgery hasn’t really given me a choice other than to sit it out for the weekend and see how it goes (at least I don’t have work so can take things slow)

[twinkly29 in reply to Mannyd25]

Just ugh to them. How unhelpful! If you feel worse over the weekend please do phone 111. A doctor there over the phone might be better anyway!